Inevitable miscarriage

Inevitable abortion is the type of miscarriage in which the changes has progress to the extent that pregnancy can not be continuous in any means.  The following are clinical symptoms in which the patient with inevitable miscarriage may present  with:-
                                         -increased vaginal bleeding
                                         -the pain the lower abdomen become worse and aggressive
                                         -speculum examination reveal the dilated internal os of the cervix
                                         - +/- rupture of membrane
                                         - products of conception may be seen coming out through the internal os.

Note that if the threatened abortion can not managed properly it become inevitable abortion.

The management of inevitable abortion focus on
 1. increase the process of extraction of products of conception from the maternal womb and
 2. maintain sterility of the abortion to prevent sepsis/infection.

Depend on excessive blood loss and the condition of the patient we have two ways management
   a). general management - the blood loss is corrected by inter-venous fluids and blood transfusion.

   b). active management- before 12 weeks -dilation of cervix and evacuation followed by curettage of the uterine cavity and
-after 12 weeks - uterine contraction is accelerated by oxytocin drip ( 10units in 500ml of normal saline ).

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